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Texas House Bill HB2274

Texas 2023 - 88th Regular

Texas House Bill HB2274 Compare Versions

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11 By: Guerra H.B. No. 2274
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44 A BILL TO BE ENTITLED
55 AN ACT
66 relating to the licensing and regulation of anesthesiologist
77 assistants; requiring an occupational license; providing an
88 administrative penalty; authorizing fees.
99 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1010 SECTION 1. Subtitle C, Title 3, Occupations Code, is
1111 amended by adding Chapter 207 to read as follows:
1212 CHAPTER 207. ANESTHESIOLOGIST ASSISTANTS
1313 SUBCHAPTER A. GENERAL PROVISIONS
1414 Sec. 207.001. SHORT TITLE. This chapter may be cited as the
1515 Anesthesiologist Assistant Licensing Act.
1616 Sec. 207.002. DEFINITIONS. In this chapter:
1717 (1) "Anesthesiologist" means a physician who:
1818 (A) holds a license in good standing issued by
1919 the medical board under Subtitle B; and
2020 (B) is certified in anesthesiology by:
2121 (i) the American Board of Physician
2222 Specialties;
2323 (ii) the American Osteopathic Board of
2424 Anesthesiology; or
2525 (iii) a certifying board recognized by the
2626 medical board.
2727 (2) "Anesthesiologist assistant" means a person who
2828 holds a license issued under this chapter.
2929 (3) "Anesthesiologist assistant board" means the
3030 Texas Anesthesiologist Assistant Board.
3131 (4) "Medical board" means the Texas Medical Board.
3232 (5) "Practice as an anesthesiologist assistant" means
3333 personally performing a medical task delegated to the person by a
3434 supervising anesthesiologist.
3535 Sec. 207.003. APPLICABILITY. (a) A person is not required
3636 to hold a license issued under this chapter to practice as:
3737 (1) a technician, assistant, or employee of a
3838 physician who performs delegated tasks but does not act as an
3939 anesthesiologist assistant or represent that the person is an
4040 anesthesiologist assistant; or
4141 (2) any other licensed health care worker acting
4242 within the scope of that person's license if the person:
4343 (A) does not use the title "anesthesiologist
4444 assistant" or the initials "C.A.A." or "A.A."; or
4545 (B) is not represented or designated as an
4646 anesthesiologist assistant.
4747 (b) This chapter does not limit the employment arrangement
4848 of an anesthesiologist assistant licensed under this chapter.
4949 SUBCHAPTER B. TEXAS ANESTHESIOLOGIST ASSISTANT BOARD
5050 Sec. 207.051. ANESTHESIOLOGIST ASSISTANT BOARD. (a) The
5151 Texas Anesthesiologist Assistant Board is an advisory board to the
5252 medical board.
5353 (b) Chapter 2110, Government Code, does not apply to the
5454 anesthesiologist assistant board.
5555 Sec. 207.052. APPOINTMENT OF BOARD. (a) The
5656 anesthesiologist assistant board consists of five members
5757 appointed by the president of the medical board as follows:
5858 (1) two anesthesiologist assistants;
5959 (2) two anesthesiologists; and
6060 (3) one member who represents the public and is not
6161 licensed or trained in a health care profession.
6262 (b) Appointments to the anesthesiologist assistant board
6363 shall be made without regard to the race, color, disability, sex,
6464 religion, age, or national origin of the appointee.
6565 Sec. 207.053. TERMS; VACANCIES. (a) Members of the
6666 anesthesiologist assistant board are appointed for staggered
6767 six-year terms. The terms of one or two members, as appropriate,
6868 expire on February 1 of each odd-numbered year.
6969 (b) A member may not serve more than:
7070 (1) two consecutive full terms; or
7171 (2) a total of three full terms.
7272 (c) If a vacancy occurs during a member's term, the
7373 president of the medical board shall appoint a new member to serve
7474 the unexpired term.
7575 Sec. 207.054. OFFICERS. The president of the medical board
7676 shall designate an anesthesiologist assistant member of the
7777 anesthesiologist assistant board as the presiding officer of the
7878 board to serve in that capacity at the will of the president. The
7979 anesthesiologist assistant board shall select from its membership a
8080 secretary to serve a one-year term.
8181 Sec. 207.055. GROUNDS FOR REMOVAL. (a) It is a ground for
8282 removal from the anesthesiologist assistant board that a member:
8383 (1) does not have at the time of taking office the
8484 qualifications required by Section 207.052;
8585 (2) does not maintain during service on the assistant
8686 board the qualifications required by Section 207.052;
8787 (3) cannot, because of illness or disability,
8888 discharge the member's duties for a substantial part of the member's
8989 term; or
9090 (4) is absent from more than half of the regularly
9191 scheduled anesthesiologist assistant board meetings that the
9292 member is eligible to attend during a calendar year without an
9393 excuse approved by a majority vote of the board.
9494 (b) The validity of an action of the anesthesiologist
9595 assistant board is not affected by the fact that it is taken when a
9696 ground for removal of a board member exists.
9797 (c) If the executive director of the medical board has
9898 knowledge that a potential ground for removal exists, the executive
9999 director shall notify the presiding officer of the anesthesiologist
100100 assistant board of the potential ground. If the potential ground
101101 for removal involves the presiding officer, the executive director
102102 shall notify the next highest ranking officer of the
103103 anesthesiologist assistant board, who shall then notify the
104104 president of the medical board that a potential ground for removal
105105 exists.
106106 Sec. 207.056. COMPENSATION; REIMBURSEMENT OF EXPENSES. A
107107 member of the anesthesiologist assistant board may not receive
108108 compensation but is entitled to reimbursement for actual and
109109 necessary expenses incurred in performing the functions of the
110110 board, subject to the General Appropriations Act.
111111 Sec. 207.057. OPEN MEETINGS; ADMINISTRATIVE PROCEDURE LAW.
112112 Except as otherwise provided by this chapter, the anesthesiologist
113113 assistant board is subject to Chapters 551 and 2001, Government
114114 Code.
115115 Sec. 207.058. TRAINING. (a) A person who is appointed to
116116 and qualifies for office as a member of the anesthesiologist
117117 assistant board may not vote, deliberate, or be counted as a member
118118 in attendance at a meeting of the board until the person completes a
119119 training program that complies with this section.
120120 (b) The training program must provide the person with
121121 information regarding:
122122 (1) the law governing anesthesiologist assistant
123123 board operations;
124124 (2) the programs, functions, rules, and budget of the
125125 anesthesiologist assistant board;
126126 (3) the scope of and limitations on the rulemaking
127127 authority of the anesthesiologist assistant board;
128128 (4) the results of the most recent formal audit of the
129129 anesthesiologist assistant board;
130130 (5) the requirements of:
131131 (A) laws relating to open meetings, public
132132 information, administrative procedure, and disclosing conflicts of
133133 interest; and
134134 (B) other laws applicable to members of the
135135 anesthesiologist assistant board in performing their duties; and
136136 (6) any applicable ethics policies adopted by the
137137 anesthesiologist assistant board or the Texas Ethics Commission.
138138 (c) A person appointed to the anesthesiologist assistant
139139 board is entitled to reimbursement, as provided by the General
140140 Appropriations Act, for the travel expenses incurred in attending
141141 the training program regardless of whether the attendance at the
142142 program occurs before or after the person qualifies for office.
143143 (d) The executive director of the medical board shall create
144144 a training manual that includes the information required by
145145 Subsection (b). The executive director shall distribute a copy of
146146 the training manual annually to each anesthesiologist assistant
147147 board member. On receipt of the training manual, each board member
148148 shall sign and submit to the executive director a statement
149149 acknowledging receipt of the training manual.
150150 SUBCHAPTER C. POWERS AND DUTIES OF ANESTHESIOLOGIST ASSISTANT
151151 BOARD AND MEDICAL BOARD
152152 Sec. 207.101. GENERAL POWERS AND DUTIES OF ANESTHESIOLOGIST
153153 ASSISTANT BOARD; MEDICAL BOARD APPROVAL. (a) The anesthesiologist
154154 assistant board shall adopt rules that are reasonable and necessary
155155 for the performance of the anesthesiologist assistant board's
156156 duties under this chapter, as provided by Chapter 2001, Government
157157 Code, including rules to establish:
158158 (1) licensing, renewal, and other fees;
159159 (2) license renewal dates; and
160160 (3) procedures for disciplinary actions.
161161 (b) The medical board, by a majority vote, shall approve or
162162 reject each rule adopted by the anesthesiologist assistant board.
163163 If approved, the rule may take effect. If the rule is rejected, the
164164 medical board shall return the rule to the anesthesiologist
165165 assistant board for revision.
166166 Sec. 207.102. GUIDELINES FOR EARLY INVOLVEMENT IN
167167 RULEMAKING PROCESS. (a) The anesthesiologist assistant board
168168 shall adopt guidelines to establish procedures for receiving input
169169 during the rulemaking process from individuals and groups that have
170170 an interest in matters under the anesthesiologist assistant board's
171171 jurisdiction. The guidelines must provide an opportunity for those
172172 individuals and groups to provide input before the anesthesiologist
173173 assistant board submits the rule to the medical board for approval.
174174 (b) A rule adopted or approved by the medical board may not
175175 be challenged on the grounds that the anesthesiologist assistant
176176 board did not comply with this section. If the anesthesiologist
177177 assistant board was unable to solicit a significant amount of input
178178 from the public or affected persons early in the rulemaking
179179 process, the anesthesiologist assistant board shall state in
180180 writing the reasons why the anesthesiologist assistant board was
181181 unable to do so.
182182 Sec. 207.103. POWERS AND DUTIES OF MEDICAL BOARD RELATING
183183 TO ANESTHESIOLOGIST ASSISTANTS. (a) The medical board shall
184184 administer and enforce this chapter.
185185 (b) The medical board shall adopt rules consistent with this
186186 chapter to regulate anesthesiologist assistants and
187187 anesthesiologists who supervise anesthesiologist assistants.
188188 (c) The rules adopted by the medical board must include:
189189 (1) a requirement that an anesthesiologist assistant
190190 assist only an anesthesiologist who is available to supervise the
191191 anesthesiologist assistant for the medical tasks delegated by that
192192 anesthesiologist; and
193193 (2) a requirement that an anesthesiologist assistant
194194 shall maintain compliance with all certification requirements,
195195 including continuing education requirements, adopted by the
196196 National Commission for Certification of Anesthesiologist
197197 Assistants or its successor organization.
198198 Sec. 207.104. FEES. The anesthesiologist assistant board
199199 shall set fees in amounts that are reasonable and necessary to cover
200200 the costs of administering and enforcing this chapter without the
201201 use of any other funds generated by the medical board.
202202 Sec. 207.105. RULES ON CONSEQUENCES OF CRIMINAL CONVICTION.
203203 The anesthesiologist assistant board shall adopt rules and
204204 guidelines as necessary to comply with Chapter 53, except to the
205205 extent the requirements of this chapter are stricter than the
206206 requirements of Chapter 53.
207207 Sec. 207.106. COMPLAINTS. The medical board shall maintain
208208 a system to promptly and efficiently act on complaints filed with
209209 the medical board regarding anesthesiologist assistants. The
210210 medical board shall maintain:
211211 (1) information about the parties to the complaint and
212212 the subject matter of the complaint;
213213 (2) a summary of the results of the review or
214214 investigation of the complaint; and
215215 (3) information about the disposition of the
216216 complaint.
217217 SUBCHAPTER D. LICENSE REQUIREMENTS, EXEMPTIONS, AND RENEWAL
218218 Sec. 207.151. LICENSE REQUIRED. (a) A person may not
219219 practice as an anesthesiologist assistant in this state unless the
220220 person holds an anesthesiologist assistant license issued under
221221 this chapter.
222222 (b) A person may not use the title "anesthesiologist
223223 assistant" or "certified anesthesiologist assistant" or the
224224 initials "C.A.A." or "A.A." or represent that the person is an
225225 anesthesiologist assistant unless the person holds a license issued
226226 under this chapter.
227227 Sec. 207.152. ISSUANCE OF LICENSE. The medical board shall
228228 issue a license to an applicant who:
229229 (1) meets the eligibility requirements of Section
230230 207.153;
231231 (2) submits an application on a form prescribed by the
232232 board;
233233 (3) pays the required application and licensing fees;
234234 and
235235 (4) submits to the board any other information the
236236 board considers necessary to evaluate the applicant's
237237 qualifications.
238238 Sec. 207.153. ELIGIBILITY REQUIREMENTS. To be eligible for
239239 a license under this chapter, an applicant must:
240240 (1) submit proof of completion of a graduate level
241241 training program accredited by the Commission on Accreditation of
242242 Allied Health Education Programs or its successor organization;
243243 (2) pass a certifying examination administered by the
244244 National Commission for Certification of Anesthesiologist
245245 Assistants or its successor organization;
246246 (3) submit proof of current certification from the
247247 National Commission for Certification of Anesthesiologist
248248 Assistants or its successor organization; and
249249 (4) meet any additional qualifications adopted by rule
250250 by the anesthesiologist assistant board.
251251 Sec. 207.154. CRIMINAL HISTORY RECORD INFORMATION
252252 REQUIREMENT FOR LICENSE ISSUANCE. (a) The medical board shall
253253 require that an applicant for a license submit a complete and
254254 legible set of fingerprints, on a form prescribed by the board, to
255255 the board or to the Department of Public Safety for the purpose of
256256 obtaining criminal history record information from the Department
257257 of Public Safety and the Federal Bureau of Investigation.
258258 (b) The medical board may not issue a license to a person who
259259 does not comply with the requirement of Subsection (a).
260260 (c) The medical board shall conduct a criminal history
261261 record information check of each applicant for a license using
262262 information:
263263 (1) provided by the individual under this section; and
264264 (2) made available to the board by the Department of
265265 Public Safety, the Federal Bureau of Investigation, and any other
266266 criminal justice agency under Chapter 411, Government Code.
267267 (d) The medical board may:
268268 (1) enter into an agreement with the Department of
269269 Public Safety to administer a criminal history record information
270270 check required under this section; and
271271 (2) authorize the Department of Public Safety to
272272 collect from each applicant the costs incurred by the Department of
273273 Public Safety in conducting the criminal history record information
274274 check.
275275 Sec. 207.155. EXEMPTIONS FROM LICENSING REQUIREMENT FOR
276276 CERTAIN ANESTHESIOLOGIST ASSISTANTS. A person is not required to
277277 hold a license issued under this chapter to practice as an
278278 anesthesiologist assistant student enrolled in an anesthesiologist
279279 assistant educational program accredited by the Commission on
280280 Accreditation of Allied Health Education Programs or its successor
281281 organization.
282282 Sec. 207.156. LICENSE RENEWAL. (a) A license issued under
283283 this chapter is valid for a term of two or more years, as determined
284284 by anesthesiologist assistant board rule.
285285 (b) On notification from the medical board, a person who
286286 holds a license under this chapter may renew the license by:
287287 (1) paying the required renewal fee;
288288 (2) submitting the appropriate form; and
289289 (3) meeting any other requirement established by
290290 anesthesiologist assistant board rule.
291291 (c) The anesthesiologist assistant board by rule may adopt a
292292 system under which licenses expire on various dates during the
293293 year.
294294 (d) A person who is otherwise eligible to renew a license
295295 may renew an unexpired license by paying the required renewal fee to
296296 the medical board before the expiration date of the license. A
297297 person whose license has expired may not engage in activities that
298298 require a license until the license has been renewed.
299299 (e) A person whose license is expired may renew the license
300300 by paying to the medical board a fee that is equal to 1-1/2 times the
301301 renewal fee for the license.
302302 SUBCHAPTER E. PRACTICE BY LICENSE HOLDER
303303 Sec. 207.201. NOTICE OF INTENT TO PRACTICE. Before
304304 beginning practice, each anesthesiologist assistant licensed under
305305 this chapter must submit on a form prescribed by the
306306 anesthesiologist assistant board notice of the license holder's
307307 intent to practice. The notice must include the name, business
308308 address, license number, and telephone number of the
309309 anesthesiologist assistant.
310310 Sec. 207.202. SCOPE OF PRACTICE. (a) An anesthesiologist
311311 assistant may assist the supervising anesthesiologist and perform
312312 duties delegated by the supervising anesthesiologist, including
313313 the development and implementation of a patient's anesthesia care
314314 plan that is consistent with the rules adopted under this chapter.
315315 (b) An anesthesiologist assistant who assists an
316316 anesthesiologist is not considered to be engaged in the practice of
317317 medicine.
318318 (c) This chapter does not limit or expand the scope of
319319 practice of a physician assistant.
320320 Sec. 207.203. NAME TAG. A person acting within the scope of
321321 a license issued under this chapter shall wear a name tag
322322 identifying the person as an anesthesiologist assistant.
323323 Sec. 207.204. IDENTIFICATION OF STUDENT. A student in an
324324 anesthesiologist assistant training program shall be identified as
325325 a student anesthesiologist assistant or an anesthesiologist
326326 assistant student. A student may not use or permit to be used on the
327327 student's behalf the term "intern," "resident," or "fellow," or
328328 another term that identifies the student as a physician or surgeon.
329329 SUBCHAPTER F. ENFORCEMENT
330330 Sec. 207.251. ADMINISTRATIVE PENALTY. (a) The medical
331331 board by order may impose an administrative penalty against a
332332 person who violates this chapter or a rule or order adopted under
333333 this chapter.
334334 (b) The medical board shall impose the penalty in the same
335335 manner and using the same procedures as Subchapter A, Chapter 165.
336336 SECTION 2. (a) As soon as practicable after the effective
337337 date of this Act, the president of the Texas Medical Board shall
338338 appoint five members to the Texas Anesthesiologist Assistant Board
339339 in accordance with Chapter 207, Occupations Code, as added by this
340340 Act. In making the initial appointments, the president of the Texas
341341 Medical Board shall designate two members for terms expiring
342342 January 31, 2025, two members for terms expiring January 31, 2027,
343343 and one member for a term expiring January 31, 2029.
344344 (b) Notwithstanding Section 207.052(a), Occupations Code,
345345 as added by this Act, a person practicing as an anesthesiologist
346346 assistant is eligible for appointment as an initial member of the
347347 Texas Anesthesiologist Assistant Board regardless of whether the
348348 person holds an anesthesiologist assistant license issued under
349349 Chapter 207, Occupations Code, as added by this Act.
350350 SECTION 3. Not later than June 1, 2024, the Texas Medical
351351 Board with the advice of the Texas Anesthesiologist Assistant Board
352352 shall adopt the rules, procedures, and fees necessary to administer
353353 Chapter 207, Occupations Code, as added by this Act.
354354 SECTION 4. Notwithstanding Chapter 207, Occupations Code,
355355 as added by this Act, an anesthesiologist assistant is not required
356356 to hold a license under that chapter to practice as an
357357 anesthesiologist assistant in this state before September 1, 2024.
358358 SECTION 5. (a) Except as provided by Subsection (b) of this
359359 section, this Act takes effect September 1, 2023.
360360 (b) Section 207.151 and Subchapter F, Occupations Code, as
361361 added by this Act, take effect September 1, 2024.